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Abstract
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AIMS: To understand better the longstanding inequalities concerning alcohol and tobacco use, we aimed to quantify the effect of household economic security on alcohol and tobacco consumption and expenditure.
DESIGN: Longitudinal analysis using data from the Household, Income and Labour Dynamics in Australia survey (2001-2018).. SETTING: Australia PARTICIPANTS: A nationally representative cohort of 24,134 adults aged 25-64 years (187,378 observations). MEASUREMENTS: Tobacco and alcohol use (Yes/No), frequency of use of each per week, household expenditure on each per week, household weekly income (CPI-adjusted), employment security (based on conditions of employment), and housing affordability (housing costs relative to household income).
FINDINGS: At baseline, one-quarter of the sample used tobacco and 87% used alcohol. Annual increases in household income were associated with the increased use of both tobacco and alcohol for people in households in the lowest 40% of the national income distribution (OR 1.13, 95%CI 1.03-1.23 and OR 1.12, 95% CI 1.04-1.20 respectively) with no similar income effect observed for higher-income households. In relation to smoking, the odds of a resident's tobacco use increased when their household was unemployed (OR 1.32, 95% CI 1.07-1.62). In relation to alcohol, the odds of use decreased when households were insecurely employed or unemployed, or housing costs were unaffordable (OR 0.87, 95% CI 0.77-0.98, OR 0.66, 95%CI 0.55-0.80 and OR 0.84, 95% CI 0.75-0.93 respectively). This was also reflected in the reduced odds of risky drinking (defined in accordance with Australian guidelines) when housing became unaffordable or households became unemployed (OR 0.90, 95% CI 0.81-0.99; OR 0.82, 95% CI 0.69-0.98 respectively).
CONCLUSIONS: In Australia, smoking and drinking appear to exhibit different socio-behavioural characteristics and household unemployment appears to be a strong determinant of smoking.
Language: en |